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Cited by 39Diabetes Treatment and ManagementDietary Effects on HealthDiabetes Management and Research

Effects of 6 vs 3 eucaloric meal patterns on glycaemic control and satiety in people with impaired glucose tolerance or overt type 2 diabetes: A randomized trial

Papakonstantinou, E., Kontogianni, M.D., Mitrou, P., Magriplis, E., Vassiliadi, D., Nomikos, T., Lambadiari, V., Georgousopoulou, E. +1 more·2018·Diabetes & Metabolism
DOI 10.1016/j.diabet.2018.03.008
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Abstract

Background/objectives The study aimed to compare the effects of two eucaloric meal patterns (3 vs 6 meals/day) on glycaemic control and satiety in subjects with impaired glucose tolerance and plasma glucose (PG) levels 140-199mg/dL at 120min (IGT-A) or PG levels 140-199mg/dL at 120min and >200mg/dL at 30/60/90min post-oral glucose load on 75-g OGTT (IGT-B), or overt treatment-naïve type 2 diabetes (T2D). Subjects/methods In this randomized crossover study, subjects with IGT-A (n=15, BMI: 32.4±5.2kg/m 2), IGT-B (n=20, BMI: 32.5±5kg/m 2) or T2D (n=12, BMI: 32.2±5.2kg/m 2) followed a weight-maintenance diet (45% carbohydrates, 20% proteins, 35% fats) in 3 or 6 meals/day (each intervention lasting 12 weeks). Anthropometrics, diet compliance and subjective appetite were assessed every 2 weeks. OGTT and measurements of HbA1c and plasma lipids were performed at the beginning and end of each intervention period. Results Body weight and physical activity levels remained stable throughout the study. In T2D, HbA1c and PG at 120min post-OGTT decreased with 6 vs 3 meals (P<0.001 vs P=0.02, respectively). The 6-meal intervention also improved post-OGTT hyperinsulinaemia in IGT-A subjects and hyperglycaemia in IGT-B subjects. In all three groups, subjective hunger and desire to eat were reduced with 6 vs 3 meals/day (P<0.05). There were no differences in HOMA-IR or plasma lipids between interventions. Conclusion Although weight loss remains the key strategy in hyperglycaemia management, dietary measures such as more frequent and smaller meals may be helpful for those not sufficiently motivated to adhere to calorie-restricted diets. Our study shows that 6 vs 3 meals a day can increase glycaemic control in obese patients with early-stage T2D, and may perhaps improve and/or stabilize postprandial glucose regulation in prediabetes subjects.

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  • Clinical trials, both short-term and long-term, with or without caloric restriction, in various populations, have produced contradictory results regarding the association of meal frequency with body weight, postprandial glycemia, insulin resistance, and overall glycemic control.

    “Clinical trials, both short-term (14–28 days) [321,325,328,329,330,331,332] and long-term [323,324] with no caloric restriction in non-obese and obese women with PCO syndrome at an early or late stage IGT or overt early-stage T2DM, and long-term studies with caloric restriction in T2DM without [333] or with antidiabetic treatment [320,326], have produced contradictory results regarding the associ”

    From Effects of diet, lifestyle, Chrononutrition and alternative dietary interventions on postprandial Glycemia and insulin resistance (2022) · cites this paper as [324]

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Authors
Papakonstantinou, E., Kontogianni, M. D., Mitrou, P., Magriplis, E., Vassiliadi, D., Nomikos, T., Lambadiari, V., Georgousopoulou, E., & Dimitriadis, G.
Affiliations
  • Agricultural University of Athens (GR)
  • Harokopio University of Athens (GR)
  • University General Hospital Attikon (GR)
Corresponding author
Papakonstantinou, E.
ORCID
Venue
Diabetes & Metabolism
Publisher
Elsevier BV
Published
2018-06
Volume
44
Issue
3
Pages
226-234
ISSN
1262-3636 (ISSN-L)
DOI
10.1016/j.diabet.2018.03.008
OpenAlex
W2795998295
Cited by
39
References
49
Citations by year
2026: 5 · 2025: 2 · 2024: 12 · 2023: 4 · 2022: 7 · 2021: 3 · 2020: 4 · 2019: 2
FWCI
1.80
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Diabetes & Metabolism (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Health Sciences › Medicine › Physiology › Dietary Effects on Health
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Keywords
meal frequency, eucaloric diet, impaired glucose tolerance, type 2 diabetes, glycemic control, satiety, subjective hunger, postprandial blood glucose, HbA1c, hyperinsulinemia, prediabetes, weight-maintenance diet, insulin resistance
MeSH terms
Adult, Blood Glucose, Diabetes Mellitus, Type 2, Female, Glucose Tolerance Test, Humans, Insulin, Insulin Resistance, Male, Middle Aged, Satiety Response, Body Mass Index, Treatment Outcome, Glucose Intolerance, Cross-Over Studies, Postprandial Period, Meals

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